Scientific Poster Session II - MeRIT Primer Participants (Completed Research)

2022 MeRIT Primer Participants – Completed Research
  Sunday, November 12, 2023
  12:45 PM–02:15 PM

Abstract

Introduction:

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) reduce composite endpoints of cardiovascular death and heart failure hospitalizations (HFH) in patients with heart failure regardless of ejection fraction in randomized controlled trials (RCT). Initiation during HFH has benefit up to 90 days. Longer-term outcomes following HFH using real-world data, including patients potentially excluded from RCTs, are needed to verify effectiveness and safety of SGLT2i.

Research Question or Hypothesis:

In patients with Type 2 Diabetes Mellitus (T2DM) and hospitalized from heart failure (regardless of ejection fraction), does the initiation of SGLT2i during admission through 30-days post-discharge reduce heart failure readmissions over 1 year in Veterans?

Study Design:

Retrospective cohort study using national VA data comparing patients with T2DM and heart failure, recently discharged due to heart failure exacerbation, who received empagliflozin/dapagliflozin/canagliflozin versus those who were not exposed.

Methods:

Adult patients (=18 years) with T2DM and heart failure treated at VA medical centers for a HFH during CY 2015 – 2022 and at least one outpatient visit within 30 days of discharge were included. The primary outcome was readmission for heart failure within one-year, reported as hazard ratios with 95% confidence intervals for total and propensity-score matched sets. Time to first heart failure re-hospitalization assessed by multivariate Cox-regression hazards model. Safety outcomes reported as means with standard deviations.

Results:

Average age 68 years (exposed, n = 449) versus 71 years (unexposed, n = 32057) with over 97% males in both groups. In the exposed group, 54% were started treatment prior to discharge. One-year HF readmissions occurred in 12% in the exposed group versus 25% in the unexposed, HR 0.45 (95% CI 0.34-0.59) for the total cohort and HR 0.43 (95% CI 0.33-0.57) for propensity-score matched groups.

Conclusion:

Use of SGLT2i reduced heart failure readmissions when initiated during or early after a HFH.

Presenting Author

Meredith Sigler PharmD, BCPS
TTUHSC SOP

Authors

Carlos Alvarez Pharm.D., M.Sc., BCPS, MSCS
Texas Tech University Health Sciences Center

Robert Parker Pharm.D.
University of Tennessee Health Science Center

Aaron Perkins M.S.
Texas Tech University Health Sciences Center, Jerry H. Hodge School of Pharmacy